| NPI | 1194738625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: VT 006.0083894) |
| Additional Taxonomies | 111NN1001X Chiropractor, Nutrition (Licence: IL 038---007054) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2016-08-15 |